Whether it's to do with your genes or your food and drink consumption, you are told your cholesterol is high. What to do? Kevin O'Sullivan gets help in negotiating a supermarket trip.
Steering a way through the dietary claims that swamp supermarkets and the confusion of many food labels is bad enough. But when more precision is needed in determining contents and quantities of "no-no" ingredients, it's a minefield out there.
A visit to the doctor comes up with the finding that your cholesterol is elevated. In most instances, adjusting diet and increasing daily exercise is the first course of action - for those with very high "bad" cholesterol and who may be significantly overweight, medication in the form of statin drugs is usually favoured and so-called "functional foods" may not be relevant.
For those taking the first corrective course, we asked Margot Brennan, of the Irish Nutrition and Dietetic Institute, and Superquinn nutrition adviser Dr Anne Nugent to inform a typical shopping trip. We went to Superquinn in Blanchardstown, Co Dublin.
Having high cholesterol requires looking at the overall picture, Brennan says. There are "no absolutes for people", and food products in isolation are not the answer. Many foods, such as dairy products, red meat and nuts, may be naturally higher in fat yet provide key nutrients. It's all part of the balancing of dietary management.
To compound matters, Nugent says labels are often ambiguous - a product may be low in fat but, on closer investigation, be found to be high in salt. "EU changes will rectify that soon," she believes.
The pursuit of foods that are lower in fats, sugar and salt - and higher in fibre - is a good basic approach. The mission is to reduce LDL (bad) cholesterol and to increase HDL (good/protective) cholesterol levels in the blood. The recommended guideline daily amount (GDA) of fat for a woman is 70g (grams) and up to 95g for a man. "Low fat" is considered anything less than three grams per 100g of a food item, "high fat" is over 10g.
A total fat content in a product between 5g and 10g is generally acceptable. Fats determine the level of saturated fats (which raise cholesterol in the blood); usually they are about 10 per cent of total fat intake. Anything less than 1g of saturates per 100g serving is considered low. Anything above 5g is high.
Both polyunsaturated and monounsaturated fats may help lower your blood cholesterol level when you use them in place of saturated fats in your diet. But a moderate intake of all types of fat is best.
It's the fats that are "attractive" in foods, Brennan notes. "That's what we all savour. If you take fat out, you lose flavour." The dilemma for food companies is obvious.
What has become the most notorious constituent of processed foods is hydrogenated vegetable oils, or "trans fats" as they are also known. They lower HDL (good) cholesterol and raise LDL (bad cholesterol), though natural trans fats in dairy/meat products are not considered harmful as they appear not to work in the same way.
Artificial trans fats are often associated with cheaper products. Using cheaper vegetable oils leads to higher trans content. Trans fats increase shelf-life. But bigger food companies are changing product profiles in response to concerns. "In a lot of cases, trans fats are almost eliminated," Nugent says.
The order of ingredients on a label is indicative of their relative amount: ie quantities are listed in descending order. So if hydrogenated fat is the second item on the list, "you can be sure, there is a lot it", Brennan adds.
With prepared meal products, there is a significant move by supermarkets and manufacturers to reduce, if not eliminate, trans fats. Consumers still have to be watchful for fat, notably the saturated variety. Superquinn meals are now free from hydrogenated fats, and it has changed its labels and moved them to the front of the product.
"A lot more work needs to be done in this area, but it's very handy for the customer to see," says Nugent.